Nutritional modification is a key consideration for the management of diabetes. Characterization of dietary habits among adults with diabetes may help focus dietary behavior changes. Dietary intakes and hemoglobin A1c data from the 2005-2014 National Health and Nutrition Examination Survey (NHANES) were evaluated to assess differences in meal and snacking macronutrient patterns by A1c levels. Data from 20,2adults ≥ 30 years were categorized into the following groups using A1c values: <5.7% (nondiabetes, n= 12,949); 5.7-6.4% (prediabetes, n=4,892); 6.5-6.9% (controlled diabetes, n=768); and ≥7%, (poorly controlled diabetes, n=1,597). Dietary intakes were assessed via a 24 hour dietary recall. Eating occasions were defined by the participant. Data analyses were weighted to create a nationally representative sample. Overall, the mean energy intakes were higher in the nondiabetes group by up to 264 kcal. Mean protein, carbohydrate and fat intakes were also higher in the nondiabetes group. Intakes for energy and macronutrients were similar across all groups at breakfast and dinner, however, at lunch and for all snacks combined, those without diabetes had higher intakes. Intakes of added sugars at eating occasions were also higher in the nondiabetes group and snacks contributed the most for all groups. The daily total number of carb choices for the nondiabetes, prediabetes and both diabetes groups were 17, 16, 15 and 15, respectively. For all groups, dinner was the largest meal and accounted for the highest carb choice values. Despite the overall reduction in energy and macronutrient intakes in those with elevated A1c, indicating they may be making perceived positive dietary behavior changes, all the groups diets are low in quality per Healthy Eating Index. There may need to be a greater focus on changing macronutrient quality, especially carbohydrates, when developing individualized medical nutrition therapy for people with diabetes or prediabetes.


O. Kelly: Employee; Self; Abbott. Employee; Spouse/Partner; Abbott. J.L. Krok-Schoen: None. M. Luo: Employee; Self; Abbott. C.A. Taylor: None.

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